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Voruganti N, Olowofela A, Wood JC, Mansukhani NA, Lewis BD, Brown KR. Superficial femoral artery stent extrusion. J Vasc Surg Cases Innov Tech 2021; 7:794-797. [PMID: 34877440 PMCID: PMC8627900 DOI: 10.1016/j.jvscit.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/13/2021] [Indexed: 11/21/2022] Open
Abstract
The superficial femoral artery is a common location for endovascular treatment of occlusive arterial disease. Stent extrusion is an uncommon complication of stent placement. In the present case report, we sought to raise awareness of this rare complication and have described the management of a single unique case. Although rare, the complication of stent extrusion should be considered in patients with abnormal symptoms after endovascular treatment of superficial femoral artery disease.
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Borghese O, Pisani A, Funaru DA, Di Marzo L, Di Centa I. Late onset infection of covered and bare metal arterial stents. Vascular 2021; 30:960-968. [PMID: 34348520 DOI: 10.1177/17085381211036548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective was to present the case of a late covered iliac stent late infection and report a comprehensive literature review on diagnosis and outcomes in this setting. METHODS A comprehensive review of the literature was performed through MedLine by two independent reviewers from 1990 to 2020 on reported cases of arterial stent late onset infection over arterial stents. The data about on the risk factors, clinical presentation, treatment and outcomes were collected. RESULTS Twenty-two studies were selected as pertinent for the analysis, totalling 24 patients including the indexed case. Infection occurred at a median of 22 months postoperatively (range 2-120 months) over a bare metal stent in 66.7% (n 16) of cases versus 33.3% (n 8) over a covered stent. Clinical presentation included local symptoms (local pain, oedema, petechiae or skin rash) in 21 (87.5%) cases and non-specific systemic symptoms (fever, sepsis, chills and leucocytosis) in 8 cases (33.3%). In 4 cases (16.7%), patients presented with haemorrhagic shock upon arterial rupture. The bacteria most frequently encountered were S. aureus (54.2% of cases). Several factors were supposed to be responsible for the infection including among which procedure-related (non-aseptic technique, lack of prophylactic antibiotics and repetitive punctures at the access site) or related to pre-existing patient's clinical conditions (immunosuppression, diabetes and concurrent infection) have been considered responsible for the infection. Treatment consisted in antibiotics alone (2 patients, 8.3%) or in association with surgical explant, both with or and without revascularization (n 21, 87.5%). In one case, an endovascular coiling was performed. Complications occurred in 29.2% (n 7) of cases and included the need for amputation, bowel resection, endocarditis, pulmonary failure or pneumonia. Overall, three patients (12.5%) died from a septic shock or multi-organ failure. CONCLUSIONS Intravascular stent infection is a rare but fearsome condition associated with high morbidity and mortality.
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Affiliation(s)
- Ottavia Borghese
- Department of Vascular and Endovascular Surgery, Foch Hospital, Suresnes, France.,Sapienza University, Rome, Italy
| | - Angelo Pisani
- Departement of Cardiac Surgery, 55183Pineta Grande Hospital, Castel Volturno, Italy
| | - Dan Andrei Funaru
- Department of Vascular and Endovascular Surgery, Foch Hospital, Suresnes, France
| | | | - Isabelle Di Centa
- Department of Vascular and Endovascular Surgery, Foch Hospital, Suresnes, France
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Chang HY, Liu ZG, Li YL, Liu B, Wang WJ, Wang W, Wang YZ. Endovascular stenting and coil embolization for management of radiation-induced pseudoaneurysms of the peripheral arteries. J Int Med Res 2021; 49:300060520984933. [PMID: 33845651 PMCID: PMC8047089 DOI: 10.1177/0300060520984933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective This study was performed to evaluate the safety and efficacy of endovascular stenting and embolization for the management of radiation-induced peripheral arterial pseudoaneurysms. Methods Twelve consecutive patients with radiation-induced peripheral arterial pseudoaneurysms (diameter of 10–30 mm and mean size of 20.42 mm) were admitted to our hospital from 1 January 2015 to 31 October 2019. The patients’ baseline characteristics, perioperative parameters, device characteristics, and curative effects were systematically recorded and analyzed. Results The 12 patients comprised 3 men and 9 women with a mean age of 62.90 ± 13.97 years. The iliac artery was the most commonly involved artery, followed by the subclavian artery. In all patients, the pseudoaneurysms were detected by enhanced computed tomography. Twelve covered stents were deployed (7 or 8 mm in diameter and 50 mm in length). Additional coil embolization was performed in three patients (Patients 8, 9, and 10). The primary and secondary technical success rate was 91.7% and 100%, respectively. Apart from one death caused by rebleeding, no patients developed rebleeding during follow-up. Conclusion Endovascular stenting and coil embolization are feasible and effective for the management of radiation-induced peripheral arterial pseudoaneurysms in highly selected patients.
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Affiliation(s)
- Hai-Yang Chang
- Department of Interventional Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China.,Interventional Oncology Institute of Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Zhen-Guo Liu
- Department of Oncology, Gaoqing People's Hospital, Gaoqing, Shandong Province, People's Republic of China
| | - Yu-Liang Li
- Department of Interventional Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China.,Interventional Oncology Institute of Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Bin Liu
- Department of Interventional Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China.,Interventional Oncology Institute of Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Wu-Jie Wang
- Department of Interventional Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China.,Interventional Oncology Institute of Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Wei Wang
- Department of Interventional Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China.,Interventional Oncology Institute of Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Yong-Zheng Wang
- Department of Interventional Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China.,Interventional Oncology Institute of Shandong University, Jinan, Shandong Province, People's Republic of China
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